肿瘤标志物CA 125 II、CA 72-4、癌胚抗原相关细胞黏附分子（CASA）和细胞角蛋白片段21-1（CYFRA 21-1）在卵巢癌中的意义

Significance of the tumour markers CA 125 II, CA 72-4, CASA and CYFRA 21-1 in ovarian carcinoma.

作者信息

Hasholzner U, Baumgartner L, Stieber P, Meier W, Hofmann K, Fateh-Moghadam A

机构信息

Institut für Klinische Chemie, Klinikum Grosshadern, Ludwig Maximilians, Universität München, Germany.

出版信息

Anticancer Res. 1994 Nov-Dec;14(6B):2743-6.

PMID:7532929

Abstract

We compared the tumour marker CA 72-4 and the new markers CASA and CYFRA 21-1 with the established marker CA 125II in follow-up care and control of efficacy of treatment in ovarian cancer in order to determine whether there are differences in recognizing ovarian carcinomas of different histological type. The investigation was done retrospectively on serum samples frozen at -80 degrees C obtained from 262 subjects, among them 50 healthy women, 53 sera with benign gynecological diseases and 159 sera with ovarian cancer, 72 of them at the time of primary diagnosis. We used commercially available kits: CA 125 II: Centocor RIA, CASA: Medac EIA, CA 72-4: Centocor RIA and CYFRA 21-1: Boehringer EnzymunR ELISA. Fixing specificity at 95% versus benign gynecological diseases as a clinically relevant reference group, we found cut-off values of 160 U/mL for CA 125II, 6.5 U/mL for CASA, 6.8 U/mL for CA 72-4 and 2.4 ng/ml for CYFRA 21-1. Based on this specificity we can compare the corresponding sensitivities at the time of primary diagnosis (n = 72): CA 125 II 47%, CA 72-4 47%; CASA 31% and CYFRA 21-1 44%. Regarding histological types of ovarian carcinomas, we found a sensitivity of 50% for CA 125 II and CASA, 36% for CA 72-4 and 33% for CYFRA 21-1 in serous ovarian cancer (n = 53), 21% for CA 125 II and CASA, 36% for CYFRA 21-1 and 43% for CA 72-4 for mucinous ovarian cancer (n = 27). Serous ovarian carcinomas were classified by higher FIGO-stages than mucinous ovarian carcinomas. Additional sensitivities were found at the time of primary diagnosis for the combination of CA 125 II and CA 72-4 and in serous ovarian cancer for CA 125 II and CASA. According to our results, at the time of primary diagnosis the combined determination of CA 125 II and CA 72-4 is useful. If both are negative, determination of CASA can be helpful. For follow-up care and control of efficacy of treatment the preoperative positive or leading marker is sufficient.

摘要

我们将肿瘤标志物CA 72-4以及新标志物CASA和CYFRA 21-1与已确立的标志物CA 125II进行比较，用于卵巢癌治疗效果的随访监测，以确定在识别不同组织学类型的卵巢癌方面是否存在差异。该研究对从262名受试者中获取的保存在-80℃的血清样本进行回顾性分析，其中包括50名健康女性、53份患有良性妇科疾病的血清以及159份患有卵巢癌的血清，其中72份是在初次诊断时采集的。我们使用了市售试剂盒：CA 125 II：Centocor放射免疫分析试剂盒；CASA：Medac酶免疫分析试剂盒；CA 72-4：Centocor放射免疫分析试剂盒；CYFRA 21-1：Boehringer EnzymunR酶联免疫吸附测定试剂盒。以与良性妇科疾病相比95%的特异性作为临床相关参考组，我们得出CA 125II的临界值为160 U/mL，CASA为6.5 U/mL，CA 72-4为6.8 U/mL，CYFRA 21-1为2.4 ng/ml。基于此特异性，我们可以比较初次诊断时（n = 72）的相应敏感性：CA 125 II为47%，CA 72-4为47%；CASA为31%，CYFRA 21-1为44%。关于卵巢癌的组织学类型，我们发现浆液性卵巢癌（n = 53）中CA 125 II和CASA的敏感性为50%，CA 72-4为36%，CYFRA 21-1为33%；黏液性卵巢癌（n = 27）中CA 125 II和CASA的敏感性为21%，CYFRA 21-1为36%，CA 72-4为43%。浆液性卵巢癌的国际妇产科联盟（FIGO）分期高于黏液性卵巢癌。在初次诊断时还发现了CA 125 II和CA 72-4联合检测以及浆液性卵巢癌中CA 125 II和CASA联合检测的额外敏感性。根据我们的结果，在初次诊断时联合检测CA 125 II和CA 72-4是有用的。如果两者均为阴性，检测CASA可能会有帮助。对于治疗效果的随访监测，术前阳性或主导标志物就足够了。